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Is Community Intervention Effective for Improving Maternal, Newborn and Child Health Care in Hard-to-Reach Areas of Chin State, Myanmar?

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The true incidence of snakebite in Myanmar is unknown. The current data are based on hospital returns to Ministry of Health and Sports and they are likely to be under-reported. A community-based survey is useful to know the current burden of snakebite and thus for planning and formulating str

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Aims of MHSR Journal

• To serve as an important medium for the publication of original research in the field of medical science and health research, thus filling gaps in health knowledge for effective utilization of research findings
• To impart current medical knowledge and updated scientific information obtained from research to health professionals for better and appropriate health care management
• To disseminate recent basic, applied and social research findings among health personnel of different strata for enhancing worldwide health development

Archives   2006

Myanmar   Health   Sciences   Research   Journal

Volume   18,  Number   2

TITLE:   Russell's viper (Daboia russelii siamensis) bite : venom and antivenom clearance and outcome of antivenom therapy.
AUTHOR:   Tun Pe; Aye Aye Myint; Khin Aye Kyu
SOURCE:   Myanmar Health Sciences Research Journal. 2006; 18(2): 67-72
ABSTRACT:   Venom and antivenom clearance of 134 Russell’s viper (Daboia russelii siamensis) bite cases treated with a variable dose of enzyme refined equine Fab2 antivenom admitted to Taungdwingyi and Thayawady hospitals from 1994-96 were studied. In mild and moderate envenomed cases, neutralisation of venom by the antivenom was achieved within ½ to 2 hours following intravenous 2-4 ampoules of antivenom and in severe envenomed cases, 8 and 4 ampoules of antivenom in ½ and 4 hours and 4 ampoules of precipitated antivenom in 12 hours. Eight out of 22 severe envenoming cases were given an additional 4 ampoules of antivenom because of persistance of incoagulable state. A similar pattern of venom neutralisation by the antivenom was observed in prospective turns severe envenoming cases treated with 4 and 8 ampoules of the antivenom. Mean plasma half-life of the antivenom given to 17 systemic envenomed Russell's viper bite with a venom level more than 60 ng/ml is 15.0±3.58 hr (mean ±SD)(range 5.74 -34.78 hours). Neutralisation of the venom by the antivenom depends on antivenom dose and the initial venom level. A bolus dose of 8 ampoules of antivenom given to severe envenomed cases within 4 hours after the bites did not confer better protection against development of renal failure compared to those given the total in two divided doses indicating that qualitative improvement of antivenom is necessary. Use of precipitated antivenom should be discouraged. Intravenous route is preferred to intramuscular because of slow absorption of antivenom in the latter.
SUBJECT HEADINGS:   Russell's Viper. Snake Bites. Wasp Venoms. Antivenins.
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